Posts

We’ve worked closely with our customers throughout the pandemic to understand the economic and health challenges they, their employees and our communities face. Every decision we’ve made as a company during these extraordinary times is through the lens of a long-term commitment to our members and our communities, with the goal to support our customers and members, just as we always have. In many cases, we have been actively working with our customers on a one-to-one basis to identify solutions that will provide short-term relief.

Now, as a result of our ongoing discussions with customers, we’re excited to announce the COVID-19 Economic Response Program, which is designed to help new and existing fully insured employer group customers during this unprecedented national emergency.

Briefly, we’re offering a premium deferral to existing fully insured customers and a two-year rate guarantee to new fully insured customers.

The charts below provide more detail.

COVID-19 Economic Response Program for Existing Insured Customers

Customers Option Method Recoupment Plan Decision
  • Fully insured
  • Size 51+ enrolled employees*
Defer 50% of July billed medical and dental monthly premium

 

 

Line item credit on future Customer Statement**

Example: Client X deferred one monthly premium in 2020 = $240,000

 

Spread evenly across 12 monthly invoices in 2021 as a line item charge (regardless of anniversary date).

Impact is approx. 4.2% increase additional premium in 2021.

Example: Client X’s 2021 monthly invoice line item deferred premium charge = $240,000/12 = $20,000

*Account executives will help customers determine if an employer is eligible.
**Actual invoices credited will be subject to opt-in decision timing by customer. If opt-in signed form is received and processed by July 31, 2020, then credit will appear on the September Customer Statement. If received and processed after July 31, 2020, or signed opt-in form is received by Aug. 15, 2020, then credit will appear on the October Customer Statement.

COVID-19 Economic Response Program for New Insured Business (New Employer Group to BCBSTX) with effective dates from July 2020 through January 2021

Customers Option Method Recoupment Plan Decision
  • New customers with effective dates from July 2020 through January 2021
  • Fully insured
  • Size 51+ enrolled employees
Default Option 24-month rate guarantee at first 12 months rates for medical and dental No rate increases in the first 24 months. Policy year limited to 12 months and a renewal will be provided. No recoupment needed Decision and criteria will be indicated in the additional provisions of the BPA, which must be signed prior to the effective date.
Alternate Option Defer 30% of first 3 months of medical and dental premiums* Line item credits** for first 3 months will appear on customer statements for months 2-4 and recoupment over the last 8 months will appear on customer statements for months 5-12. Recoup the deferment in the remaining eight months as a line item charge with maximum 9.9% first-year renewal increase for medical and maximum 5.0% first-year renewal increase for dental

 

Decision and criteria will be indicated in the additional provisions of the BPA, which must be signed prior to the effective date.

Exceptions will be made for July and August 2020 effective dates to process and sign a revised BPA given the timing of the release of the COVID-19 Economic Response Program.

*Account executive to work with underwriter to capture and document.
**Actual invoices credited will be subject to opt in to this option and decision timing by customer.

Who’s eligible?
Most fully insured groups 51+ enrolled employees will be eligible.

Who isn’t eligible?

  • Self-funded groups, MPP, Cost+, ACA-rated small groups, Blue Balance FundedSM, student health, ADM, MEWA/PEO, association health plans, retrospective premium accounts, customers on private multi-carrier exchanges, and prospective retention accounts.
  • Accounts in stage two of delinquency are also not eligible, but those groups will be given a chance to rectify that status by July 31, 2020, so that they may qualify. (Stage two delinquency is defined as accounts with payments that are 30 days past due.)

 

Looking for BCBS o Texas Contracting?  Look no further…

Get Contracted Now

 

 

Applies to: All Groups, All Markets: We have signed a new multi-year contract with Kelsey-Seybold Clinic Leaving site icon. The new agreement will provide access to value-based care for our members in the Houston area. Members in our Blue Essentials HMOSM and Blue Choice PPOSM provider networks can receive in-network care at Kelsey-Seybold Clinics starting Jan. 1, 2020.

“We are pleased that we have reached an agreement with Kelsey-Seybold Clinic, enabling us to again offer their exceptional care to our members,” said Dr. Dan McCoy, president of Blue Cross and Blue Shield of Texas. “The contract reflects our mutual commitment to meeting the needs of our members and their patients.

“Kelsey-Seybold’s model of care aligns with our resolve to contract with providers that embrace a high-quality, value-based, collaborative and holistic approach to care for their patients and our members while working to reduce overall health care costs.”

“We are excited to be in-network with BCBSTX and offer our proven model of Accountable Care to patients, families and employers in the region. Our physicians and clinic staff look forward to welcoming BCBSTX health plan members beginning Jan. 1 at our expanding network of multispecialty care locations,” said Dr. Tony Lin, chairman of Kelsey-Seybold Clinic. “At Kelsey-Seybold Clinic, our Accountable Care model is delivering value by increasing access to care, improving quality and patient satisfaction, and directing care to appropriate settings, which helps to lower the total medical cost.”

 

Looking for BCBS o Texas Contracting?  Look no further…

Get Contracted Now

Open Enrollment: Tools for Success: Here are some essential tools for marketing and selling our 2020 qualified health plans in the individual market to existing members and new prospects.

Plan Information:

Get links to 2020 Plan Comparison Charts, Summaries of Benefits and Coverage and Benefit Highlights in this new flier PDF.

Renewal Packets:

Active members of retail plans should be receiving their renewal packets for 2020. Here are the details PDF, including links to sample packets.

Retention Call Center:

Your clients can access a special retention call center for producer sold business PDF to help renewing members through open enrollment. When your clients use the call center, you remain the producer of record.

Retail Producer Portal:

The portal allows you to complete and submit enrollment applications for your clients. Control the entire sales cycle from quote to effectuation. For details, see our guide PDF.

Agency Alert Re: Marketplace Registration:

Writing producers must be registered with the Marketplace before helping clients enroll in Marketplace policies. See our Agency Alert for details PDF.

SMALL GROUP (1-50)

2020 No Contribution/No Participation Option Period Starts Nov. 1

If your new ACA/small group (1-50 employees) wants to elect the No Contribution/No Participation Option,

follow these directions and deadlines.

 

Looking for BCBS o Texas Contracting?  Look no further…

Get Contracted Now

 

 

Applies to: Small Groups: (1-50 employees) / Deadline: December 16, 2019: From Nov.1 through Dec.15, 2019, small groups purchasing ACA/Metallic plans may opt to waive participation and contribution requirements.

The No Contribution/No Participation Option is available to new groups:

* Applying for coverage during the annual open enrollment period

* Sold during the open enrollment periods for Jan.1 and Jan.15, 2020, effective dates

Submission dates and deadlines:

If your new ACA/small group wants to elect the No Contribution/No Participation Option, please submit the small group enrollment with all required documentation via the ACA Small Group Enrollment tool between Nov. 1 and Dec.16, 2019.

* The group must sign the enrollment paperwork by Dec.15, 2019, and we must receive the enrollment by Dec.16, 2019.

* If we receive the enrollment after Dec.16, standard small group participation and contribution levels will apply.

 

Looking for BCBS o Texas Contracting?  Look no further…

Get Contracted Now

READY, SET, QUOTE!
2020 ACA Small Group (1-50) new business plans are now available for quoting.
The plan designs and rates for new groups can be found in Blue Access for Producers on the eSales Tools home page for Jan. 1, 2020, effective dates. If you have any questions, please contact your sales executive or general agent.

Review Helpful Changes to Small Group Paperwork Due Date and HMO Disclosure Form.If you need a few extra days to submit December renewals or want to reduce the number of required forms, we have you covered. Find out how we’re making the Q4 rush easier.

Group:

New This Fall: Producer Ancillary Bonus Program

Learn about the new, expanded producer bonus program for Blue Cross and Blue Shield of Texas (BCBSTX) ancillary products. These include life, disability, dental, vision, critical illness and accident insurance. Our new program PDF will provide you the ability to earn:

* Up to a 5undefined for persistence on existing case

Big picture:

The updated incentive program for 2020 business was designed with producer feedback to improve the dental program. It will align with and complement the Medical Package Pricing that rolled out for medical and ancillary in September. For questions, contact your BCBSTX representative.

Q4 Is Here; Get Your Mid-market Quotes Faster

Want to know how to get your 2020 quotes back quickly? See our mid-market quoting tips.

Contact our Enrollment Support Team at 1-866-590-9771 or support@enrollinsurance.com for more BCBS information.

Blue Advantage HMOSM Provides State-wide Access to Doctors, Specialists: Small Groups (1-50): 2020 renewals are almost here, and Blue Advantage HMO is front and center as a cost-saving solution. Don’t let concerns about network adequacy stop your clients from taking advantage of savings opportunities.

We Can Help Dispel Myths About HMOs

We listened to your feedback on HMO network adequacy concerns. Next week, we’ll send another targeted message to groups with January 2020 renewal dates to talk about the thousands of Blue Advantage HMO PCPs and specialists located across the state.

We want to help you dispel myths about HMOs and encourage employers to talk with you about how a dual option in 2020 can be the cost-saving advantage they need.

Our message is simple; Blue Advantage HMO is statewide:

– Covering all 254 counties

– 8,442 participating PCPs

– 39,938 specialists

Materials to Help You Sell

The fliers and video below can help employers understand how Blue Advantage HMO covers each Texas region, and they show the similarities between modern HMO and PPO benefits.

Myth Buster Video: Doctors and Hospitals Don’t Take HMOs

Blue Advantage HMO Regional Fliers

– Austin

– DFW

– East Texas

– Houston

– San Antonio

– South Texas/Valley

– West Texas

Want to Talk?

Please call the Texas Small Group Account Management Team at 877-239-5582 with questions. We know you don’t want to miss out on cost-saving opportunities for your clients.

Source Link: http://www.bcbstxcommunications.com/newsletters/nftb/2019/1002/stories/NLT_PROD_NFTB_TX_100219_BLUE_ADVANTAGE.html